Provider Demographics
NPI:1922798594
Name:VIRTUAL MILESTONE ACADEMY
Entity Type:Organization
Organization Name:VIRTUAL MILESTONE ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCC-SLP, C-SLDI
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:HORNE
Authorized Official - Last Name:CAWLFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:337-303-4863
Mailing Address - Street 1:222 E DUNBAR LN APT 309
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3273
Mailing Address - Country:US
Mailing Address - Phone:337-303-4863
Mailing Address - Fax:
Practice Address - Street 1:222 E DUNBAR LN APT 309
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3273
Practice Address - Country:US
Practice Address - Phone:479-856-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty